Comparison Between Two Volumes of 70% Alcohol in Single Injection Ultrasound-Guided Celiac Plexus Neurolysis: A...

Area of Science:

• Interventional Pain Management
• Gastroenterology
• Oncology

Background:

• Pain from inoperable upper abdominal malignancies requires multimodal analgesia.
• Celiac plexus alcohol neurolysis (CPN) is effective for pain relief, but optimal alcohol volume is debated.
• Balancing neurolytic and destructive effects of alcohol is crucial for CPN efficacy.

Purpose of the Study:

• To compare the analgesic efficacy of two different alcohol volumes in ultrasound-guided CPN.
• To determine the optimal volume of 70% alcohol for managing abdominal cancer pain.
• To improve outcomes of interventional pain management for advanced malignancies.

Main Methods:

• A randomized controlled double-blinded clinical trial was conducted.
• Thirty-two patients with unresectable abdominal malignancies received ultrasound-guided CPN with either 20 mL (CPN20) or 40 mL (CPN40) of 70% alcohol.
• Primary outcome: post-procedure pain score (VAS); Secondary outcomes: opioid consumption and quality of life (QOL).

Main Results:

• No significant difference in VAS pain scores between CPN20 and CPN40 groups at any time point.
• Both groups showed significant pain reduction compared to baseline.
• No significant differences in daily opioid consumption or QOL between groups; both improved from baseline.

Conclusions:

• A 20 mL volume of 70% alcohol is as effective as 40 mL for ultrasound-guided CPN in managing pain from inoperable upper abdominal cancers.
• The findings suggest 20 mL is sufficient for effective pain control, opioid reduction, and QOL improvement.
• Further large-scale, multicenter studies are recommended to validate these results.